Health Connection - October 2020

Flu Season and COVID-19: What You Should Know

Influenza (flu) season is officially here, and this year it’s a bit more unpredictable than usual. Protecting the population from the flu every year depends on an annual vaccine – developed months in advance – that effectively counters the strains that end up spreading around the world.

Experts all agree that getting a flu shot now can help keep you healthy and well this winter. In fact, the CDC recommends that everyone over the age of 6 months should receive a flu shot with very few exceptions. MarinHealth has made it safe and easy to get a vaccination at our convenient drive-through flu clinics in Novato and Larkspur. Learn more or schedule your flu shot.

In addition to getting your flu shot, there are other steps you can take to stay safe. The good news is that many of the precautions we’ve been taking during the pandemic will also help protect against the flu. The influenza virus is transmitted through infected droplets in the air – often when an infected person coughs or sneezes, so wearing masks can help contain the spread. Being vigilant about good hygiene practices can also help protect you and your family. Continue to wash your hands frequently with soap and warm water for at least 20 seconds. Disinfect shared surfaces or high touch areas at least daily. Carry hand sanitizer with you and use it liberally when running essential errands outside of your home.

If you or a family member become ill, monitor your symptoms carefully. Because some of the symptoms of COVID-19 are similar to those of the flu, it can be difficult to differentiate between the two. Common symptoms for both can include fever or chills, cough, difficulty breathing, fatigue, sore throat, runny nose and muscle aches. A change in or loss of your sense of smell or taste is a symptom that is unique to COVID-19. Learn more about the differences in symptoms.

If you think you may have COVID-19, it’s important to talk to your doctor and get tested. MarinHealth’s Adult Acute Care Clinic provides COVID-19 testing and care, and offers convenient options including drive-thru testing, extended hours and telehealth appointments. Learn more or call 1-628-336-5205 for an appointment.

Turning 64 or Older? What You Should Know About Medicare

Whether you’re approaching Medicare age or are already there, you’ve got some thinking to do before picking a plan. You’ll have to factor in your income, your general health and whether you would like to keep your current physicians. If you’re still working and have employer coverage, you need to find out if you have the option of keeping this coverage and whether that’s in your best interest.

If you are just learning about Medicare benefits, the best place to start is by visiting Medicare.gov. It’s packed with all of the latest information on the ABCDs of Medicare to help you sort fact from fiction and understand your options. However, as Ivan Lopez, a licensed insurance agent who works with MarinHealth partner Canopy Health explains, you will have to do your research if you choose Medicare Part C, also known as Medicare Advantage. “When it comes to C, each county has their own plan,” Ivan explains. “Some snowbirds I know were surprised to find that when they bought their Medicare Part C in Florida, it did not apply in their home state of Michigan.”

Regardless of what Medicare plan you’re interested in, consider talking to an insurance broker who specializes in Medicare. Brokers do not charge you for this advice and it’s well worth taking the time to talk to one. As Ivan points out, “Not everybody is the same. So, what we like to do is tailor a plan that works for you, your lifestyle and work situation, your medications, your doctors… all that kind of stuff just to make sure you’re in the right plan.” Like Ivan, most brokers are happy to have this meeting by phone or on a Zoom call.

Another advantage of working with a broker is that they can handle the enrollment FOR you. Ivan lists several easy ways he can help. “I can do your online enrollment in less than five minutes. I can send you an email that you simply open and type your name in, on your phone or computer, and you’re enrolled. I can scan and email you an application and have you fill it out and fax it back to me. I can eve mail you an application via snail mail. Whatever is easiest for you, we can make it happen.”

MarinHealth has two new podcasts featuring Medicare plan experts to help you sort it all out. If you are new to Medicare, our Aging into Medicare – What You Need to Know podcast is a great overview of how Medicare works. To better understand your options, and the pros and cons of each, check out our Open Enrollment for Medicare Participants podcast.

Regardless of what plan you end up choosing, you’ll want to stay as healthy as possible as you age. It’s essential to have a good primary care physician (PCP) to oversee your overall health, treat issues as they come up, and recommend specialists and healthcare resources you may need. If you haven’t found the right doctor yet, MarinHealth Medical Network is a great place to start. We have excellent primary care physicians and accomplished specialists conveniently located in our MarinHealth | UCSF Clinics throughout the North Bay.

Our doctors are also backed by MarinHealth Medical Center, the newest, most modern hospital in the state of California. The hospital building has an expanded Emergency Department, a level-3 trauma center, advanced imaging, a maternity center and spacious all-private patient rooms. Impressive technology is everywhere, from robots that use UV light to disinfect patient rooms to hybrid surgery suites where our surgeons can do a wide variety of procedures, from balloon angioplasties to open heart surgery, just by switching out equipment attached to a ceiling boom. Learn more about our new Oak Pavilion.

If you’d like help finding a doctor, click here or call 1-415-275-3388 and tell us what you’re looking for in a primary care physician. We’ll help you find a doctor that’s a good match for you.

Open Enrollment: Finding that Perfect PCP

Between COVID-19, bad air quality, flu season and the added stress of living in these challenging times, it’s more important than ever to stay healthy and well. Yet many people still don’t have a Primary Care Physician, or PCP. Open Enrollment, which for those with commercial insurance begins on Sunday, November 1 and runs through Sunday, January 31, is the perfect time to remedy that. It’s also your opportunity to change your doctor if you so desire.

What is a PCP?
A PCP is often referred to as your “healthcare quarterback”–the doctor that manages your overall health. Your PCP’s responsibilities include:

• Diagnosis and treatment of most illnesses and injuries
• Preventative care, including routine screenings and vaccinations
• Providing you with wellness education and advice
• Medication management
• Helping you manage chronic conditions
• Referring you to a specialist when needed

Who is a PCP?
There are several types of Primary Care Providers:

• An Internist is a PCP who treats only adults.
• A Family Practitioner cares for patients of all ages through all stages of life.
• A Pediatrician specializes in caring for children from birth through age 18.
• An OBGYN specializes in women’s health. Some OBGYNs only focus on pregnancy and childbirth, but others also offer primary care. However, check with your insurance provider because some don’t classify OBGYNs as primary care specialists.
• A Nurse Practitioner is an advanced practice registered nurse licensed to diagnose and treat disease, oversee health management, and prescribe medication.

Picking a Provider
Choose wisely, and your relationship with your PCP can last a lifetime. In some ways, your doctor knows you better than your closest friends. It’s essential to choose someone with whom you can enjoy open communication–someone who knows how to listen and understands your lifestyle and priorities. Here are some things to consider:

• Gender. Do you feel more comfortable with a male, or female provider?
• Language and culture. If English is a second language for you, you may prefer a physician who speaks your native tongue. You may also want to choose a physician who understands your cultural and religious preferences if they could affect your care.
• Location. Think about whether you’d prefer a doctor near home or near work.
• Online Convenience. The MarinHealth Medical Network has a secure, online portal, powered by UCSF Health, where you can access your records, refill prescriptions, and email your doctor anytime. Our doctors also offer video visits for your safety and convenience.
• Insurance accepted. You’ll want to make sure your provider of choice is covered by your insurer.
• Hospital resources. MarinHealth Medical Network physicians have direct access to the resources of with MarinHealth Medical Center, a mainstay of North Bay healthcare since 1962.

Not sure how to choose a Primary Care Physician? This short podcast has tips to get you started. Listen now.

Why Choose a MarinHealth PCP?
Choosing a MarinHealth PCP gives you access to everything the MarinHealth Medical Network has to offer. We have the North Bay covered, with:

• Excellent PCPs and accomplished specialists
• Convenient MarinHealth | UCSF Health Primary Care and Specialty Clinics in Marin, Napa, and Sonoma. See locations
• Telehealth (video) visits for your safety and convenience
• Stringent safety precautions if an in-person visit is necessary

If you need specialty care, our PCPs can refer you to one of our experienced specialists or subspecialists, including renowned experts from UCSF Health. The care our doctors provide is backed by MarinHealth Medical Center, with its state-of-the-art new Oak Pavilion, advanced technology, and leading-edge capabilities. If you haven’t seen our recently opened Oak Pavilion, learn more or take a tour here.

Ready to find a Primary Care Doctor who’s right for your needs? Click here or call 1-415-275-3388 for assistance in finding a MarinHealth Medical Network physician.

Food for Thought: Understanding Popular Diet Plans

By Pamela Riggs, MS, RDN, CSOWM

From keto to DASH to flexitarian, there are a host of different popular diets these days. How do you make sense of it all? Which of these diets, if any, are right for you? Below is an overview of some of today’s most popular ways of eating. These are not necessarily weight loss diets, although they can be tweaked to help you shed pounds, with a little advice from your doctor or a dietitian.

The Mediterranean Diet

A traditional Mediterranean diet is a primarily plant-based diet, characterized by a high consumption of fruits, vegetables, legumes, whole grains, olive oil and fish. Meat and dairy products are consumed on a very limited basis.

Foods: Key components of this diet include: olive oil, dark leafy greens, beans, lentils, feta cheese, yogurt, and lots of herbs and spices, garlic, onions and lemon. It is recommended that you avoid refined and processed grains, foods with added sugars, and processed meats.

Pros: Variety, flavor, and an abundance of vitamins, minerals and phytonutrients. Controlled trials show that this type of diet significantly lowers the risk of many health conditions including: heart attacks, stroke, cardiovascular disease deaths, type 2 diabetes, and breast cancer. As a healthy lifestyle change, this diet is easy to follow without feeling deprived.

Cons: This diet requires some strategic shopping and basic cooking skills.

The Ketogenic (Keto) Diet

Originally prescribed and still used to help control seizures in children with epilepsy, the ketogenic diet has been around for decades. Today, most of us have heard of the “keto”diet a popular weight loss approach distinctive for its exceptionally low carbohydrate, high-fat content (with fat typically accounting for 70% to 80% of calories), and only a moderate intake of protein. Because the keto diet severely limits the consumption of carbohydrates, it deprives your body of glucose, your main source of energy. Instead, the body turns to an alternative fuel called ketones (a state of ketosis), produced from stored body fat.

Foods: This is a very low-carb diet. That means avoiding all flour-based products, food and beverages with added sugars, starchy vegetables including corn, squash, and potatoes, most fruits, and legumes. Foods that fit into this diet plan include high fat foods like avocado, nuts, seeds, cheese, eggs, bacon, salmon, beef and poultry; and non-starchy vegetables like salad greens, cauliflower, broccoli, and summer squash. Fruits such as berries, which are lower in sugar, are allowed in very small potions.

Pros: Ketosis tends to decrease the appetite. Studies have also shown beneficial metabolic changes (weight loss, blood sugar regulation) in the short term, but long term studies are still needed.

Cons: This diet can be difficult to maintain. Extremely low carbohydrate intake can lead to fatigue, irritability, headaches and constipation. Concerns about the long-term effects of ketogenic diet include increased risk of kidney stones, osteoporosis and heart disease. People with diabetes looking to keep their blood sugar in check should seek the advice of their doctor before attempting this diet. The “Keto” diet for weight loss has not been proven to be any more effective than traditional diets that focus on reducing calories.

The Dash Diet

DASH stands for Dietary Approaches to Stop Hypertension. Developed with the goal of lowering blood pressure, this diet emphasizes protein, fiber, potassium, magnesium and calcium from fruits and vegetables, beans, nuts, whole grains and low fat dairy.

Foods: The DASH diet allows for a variety of whole grains (e.g. brown rice, whole wheat pasta, steel cut oats). Recommended foods include fruits, vegetables, low fat milk and yogurt, fish, eggs and poultry, nuts, seeds, legumes, and olive oil. Foods to avoid include sweets, sugar sweetened beverages and foods high in sodium such as salted nuts, canned soup, and packaged and processed foods.

Pros: Scientifically proven to lower blood pressure, the DASH dietis nutrient rich, anti-inflammatory, and low in sodium and saturated fats.

Cons: Sticking to a low saturated fat and low sodium diet is a challenge if you don’t cook meals at home, rely on pre-made meals, or eat out a lot.

DASH is more of a lifestyle change than a weight loss diet. Multiple studies have shown that the DASH diet lowers blood pressure and LDL cholesterol in the blood. For help implementing this diet, visit www.nhlbi.nih.gov/health-topics/dash-eating-plan and/or consult a Registered Dietitian Nutritionist.

The Flexitarian Diet

The Flexitarian diet is a semi-vegetarian diet that emphasizes fruits, vegetables, whole grains, legumes, nuts and seeds.

Foods: This mostly vegetarian diet still allows for occasional servings of meat, poultry, fish and dairy. As with any healthy eating plan, it is recommended that you limit refined and processed foods like white bread, cookies, candy, sugar sweetened beverages, fried foods, and fatty or processed meats.

Pros: Without proper planning, strict vegan diets can fall short of important nutrients like omega 3 fats, iron, and B12. By allowing for the occasional consumption of animal protein, a flexitarian eating plan can help provide some of these nutrients.

Cons: If you are a big meat eater, it’s very easy to overdo the animal protein on this diet. Aim for at least 14 meatless meals a week.

As its name suggests, this eating plan allows for a lot of flexibility, which makes it less restrictive than many eating plans and relatively easy to follow. When you allow yourself some meat, fish or poultry, it should take up no more than 25% of your plate. The rest of your plate should ideally be 50% vegetables and 25 % whole grains such as brown rice, quinoa, barley, or farro. Try a new vegetarian recipe each week as a way to expand your options for more meatless meals.

Intermittent Fasting:

This dieting approach relies on a time restricted eating pattern. There are two popular patterns of intermittent fasting. The 5:2 method involves eating normally five days a week and then fasting (severely limited calories) two days a week and the 16:8 method involves consuming normal food intake within an eight hour window (such as 10 am to 6 pm) and then fasting (no calories at all) for the other 16 hours. Intermittent fasting reduces the need for insulin (the hormone made by the pancreas) for extended periods of time. This in turn, allows your body to burn body fat to meet your energy needs and may lead to weight loss.

Foods: While intermittent fasting does not rule out specific foods, it’s a good idea to stick to the recommendations of either the Mediterranean or Flexitarian diets. Limit your consumption of animal protein, sugar, and fatty, fried, or processed foods, and eat a colorful balance of more nutrient dense vegetables and fruits.

Pros: Intermittent fasting when done properly and consistently has been found to be helpful for weight loss. Other health benefits of intermittent fasting are being studied including reducing the risk of Alzheimer’s Disease, diabetes, and cardiovascular disease.

Cons: Depending on your routine, intermittent fasting may be hard to implement and sustain.

Before you adopt a new way of eating, ask yourself what you really want and why. Do you want to lose weight? Reduce your risk of developing a chronic disease? Improve your appearance? Then, talk to your doctor about the safest and most sustainable way to achieve your health goals. The team of Registered Dietitian Nutritionists at MarinHealth can help you plan a healthy and sustainable diet that’s best for your needs. Learn more.

Pamela Riggs is a Registered Dietitian Nutritionist at MarinHealth Medical Center.

COVID-Safe Halloween Fun

Moms and Dads are hearing some boos this Halloween, and not the spooky kind! Many youngsters are voicing their disappointment because their parents are following the CDC recommendations and local guidelines to skip the traditional, door-to-door trick-or-treating this year. Avoiding trick-or-treating will help keep your children—and the entire community—safe, but it doesn’t mean you have to avoid celebrating. Fortunately, there are plenty of creative alternatives for family Halloween fun.

Give out treats SAFELY
Some neighborhoods are planning socially distanced trick-or-treating. That means no knocking on doors! Consider making treat bags ahead of time and putting them outside. If you have a front yard and you’d still like to see the neighborhood kiddos in their costumes, try setting up a table outdoors and give treats out in prefilled bags or paper cups. This can work for drive-by trick or treating as well.

Reverse Trick-or-Treating
This idea requires a little neighborhood coordination. Much like COVID-19 birthday parties, reverse trick-or-treating involves driving. Kids put on their costumes and gather in the front yard as parents cruise around the neighborhood, tossing treats out the car window. When the kids start to get antsy, it’s time to switch places. Have them hop in the car with you and take a slow drive around the neighborhood, tossing out treats to their neighborhood friends.

Trick-or-Treat Virtually for UNICEF
Take part in UNICEF USA’s virtual Trick-or-Treat for UNICEF experience. Starting October 1, teachers, parents and children can register for their digital orange collection box, participate in fun activities, and help raise money to provide humanitarian aid for children all over the world.

Get crafty
Enjoy some creative family time with Halloween art projects. All it takes is a little Googling and you’ll discover Halloween crafts for kids of all ages, from skeleton earrings to papier-mâché masks. Use permanent markers to decorate cloth or surgical face masks, and give prizes for the scariest ones. This is also an opportunity to make some spooky spider webs and ghosts to decorate your house and yard.

Borrow from other holidays
Piñatas aren’t just for birthdays anymore. Pick up a Halloween Piñata and let the kiddos swing away. And why wait for Easter to have an egg hunt? Order some glow-in-the-dark plastic eggs, fill them with candy, hide they around the house and yard, turn out the lights, and pass out flashlights for a night-time egg hunt. Make some spooky ornaments with your kids and decorate a Halloween tree. (Yes, they come in orange!)

Spooky online fun
Host a Zoom party for family or your child’s friends. Ask guests to carve a pumpkin in advance and have everyone vote on the best one. Have a costume contest. Create a spooky playlist for background music. Turn out the lights and take turns telling scary stories. If your child isn’t much of a party animal, look into virtual escape rooms for a different kind of online fun.

Plan a scary movie night
Put out a few candles, turn out the lights, and turn on the TV. Then snuggle up on the couch and watch a spooky movie together. Choose wisely: What’s scary to a 12-year-old could be downright terrifying to a younger child. Here are some great suggestions for kids of all ages.

Bake up some boos
Stock up on baking supplies, orange food coloring, and sprinkles and have a Halloween baking session. You can find all sorts of fun Halloween cookie molds and cupcake decorations online.

Halloween outings
Just because you’re not taking the kids trick-or-treating this year doesn’t mean you all have to stay home. Here are a few fun, safe outings you might consider:

• D-through haunted house. Search online for “haunted roads” or “drive thru haunted houses” to see if there is one near you!
• Pumpkin patch. Pumpkin patches are limiting attendance to avoid overcrowding and taking safety precautions, including with cashless payment, masks, hand sanitizer. Make sure to check the weather because some pumpkin patches are closing due to bad air quality.
• Drive-in theater. Drive-in movie theaters are making a comeback. The Lark Drive In at the Village in Corte Madera has plenty of spooky options to choose from this month.
• Marin Center Halloween Fair Food Drive-Thru Spooktacular. From October 23 to November 1, the Spooktacular will be open from 4 to 9 pm on weekdays and 11 am to 9 pm on weekends. Put on your costumes and pile into the car—all the activities are drive-through!

Whatever you do, make sure you take lots of pictures or videos of your celebrations. This year is certainly unique, and the memories you create should last a lifetime!